Individual provider Active NPI

Yesenia Rivera, PSY.D.

  • Clinical Psychologist
  • Guaynabo, PR
National Provider Identifier
1548573298
Registry record updated May 21, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
4185 Issued in PR
Practice address
44 Calle Carazo
Oficina 2D
Guaynabo, PR 00969-5603
Phone
(787) 615-0782
NPI assigned
Jul 23, 2010
Last updated
May 21, 2012By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 21, 2012

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Development & Aging Psychologist 103TA0700X 4185 PR
Clinical Psychologist 103TC0700X 4185 PR Primary
Clinical Child & Adolescent Psychologist 103TC2200X 4185 PR
Family Psychologist 103TF0000X 4185 PR

Addresses

Primary practice location

44 Calle Carazo
Oficina 2D
Guaynabo, PR 00969-5603

Mailing address

PO Box 1676
Guaynabo, PR 00970-1676
Phone (787) 731-6966

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PR
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20120522000749 PR Practitioner - Clinical Psychologist 7719140151 Practice locations: Guaynabo, PR

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
4185PRMDFamily Psychologist

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1279843200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1337558400000",
    "number": "1548573298",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1676",
            "city": "GUAYNABO",
            "state": "PR",
            "postal_code": "009701676",
            "telephone_number": "787-731-6966"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "44 CALLE CARAZO",
            "address_2": "OFICINA 2D",
            "city": "GUAYNABO",
            "state": "PR",
            "postal_code": "009695603",
            "telephone_number": "787-615-0782"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RIVERA",
        "first_name": "YESENIA",
        "name_prefix": "Dr.",
        "credential": "PSY.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-07-23",
        "last_updated": "2012-05-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TA0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Adult Development & Aging",
            "state": "PR",
            "license": "4185",
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "PR",
            "license": "4185",
            "primary": true
        },
        {
            "code": "103TC2200X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical Child & Adolescent",
            "state": "PR",
            "license": "4185",
            "primary": false
        },
        {
            "code": "103TF0000X",
            "taxonomy_group": "",
            "desc": "Psychologist, Family",
            "state": "PR",
            "license": "4185",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Guaynabo, PR

Sources for this page

Verify at the official NPI Registry.